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Author Spotlight: Advancements and Challenges in Hepatitis B Virus Detection
Published on: December 15, 2023
Follow-up value of serum AFP and aminotransferases in chronic hepatitis B progression
Mengyao Yu1,2, Lei Huang3, Shichang Zhang1,2
1Department of Laboratory Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
Insights
Serum alpha-fetoprotein (AFP) and liver enzymes like AST can predict chronic hepatitis B (CHB) progression. A combined AFP and AST model accurately distinguishes remission from progression, aiding clinical assessment.
Area of Science:
- Hepatology
- Viral Hepatitis Research
- Biomarker Discovery
Background:
- Chronic viral hepatitis (CH) precedes cirrhosis and cancer.
- Standardized CH assessment is crucial for treatment and quality of life.
- Chronic hepatitis B (CHB) requires long-term monitoring.
Purpose of the Study:
- To analyze multiple serum indexes in CHB patients.
- To evaluate the combined diagnostic value of serum indexes.
- To discuss clinical applications for CHB progression assessment.
Main Methods:
- Analysis of 503 laboratory data points from 103 CHB patients (2012-2021).
- Patients categorized into remission and progression groups.
- Time-dependent modeling of serum index fluctuations.
Main Results:
- Elevated serum alpha-fetoprotein (AFP) associated with hepatocyte markers (AST, ALT) in remission.
- Higher AFP and AST levels correlated with longer progression-free periods (P < 0.0001).
- A model using AFP and AST achieved 83% reliability in distinguishing patient groups.
Conclusions:
- A quantitative relationship exists between serum AFP, liver aminotransferases, and antiviral response.
- A model-based equation can aid CHB progression assessment.
- This approach may supplement hepatitis B virus DNA detection in outpatient follow-up.
Introduction:
Chronic viral hepatitis (CH) is a stage prior to cirrhosis and primary cancer. Standard protocols for CH assessment during the long follow-up period are of great importance for precise treatment and living quality improvement. In this study, we aimed to analyze multiple serum indexes in chronic hepatitis B (CHB)-infected patients and to discuss their combined values in clinical applications.
Methods:
Total 503 lines of laboratory data from 2012 to 2021 were extracted from103 CHB patients who were followed-up in our hospital. They were divided into the remission group and the progression group according to their complete clinical information and laboratory data. A series of models of serum indexes were analyzed to illustrate the fluctuation trend of @ach index in a time-dependent manner.
Results:
The models revealed that abundant serum alpha-fetoprotein (AFP) in the remission group was characteristically associated with hepatocyte destruction markers aspartate aminotransferase (AST) and alanine aminotransferase and favored a much longer progression-free period (P 0.0001). A model-derived equation consisting of serum AFP and AST values showed a good performance (83% reliability) to distinguish the two groups.
Discussion:
This study clearly demonstrates the intrinsic quantitative relationship between serum AFP and liver aminotransferases involving antivirus treatment response. The model-based equation compensates for serum hepatitis B virus DNA detection during outpatient follow-up and it may serve as a useful laboratory tool for CHB progression assessment.
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